20.500.12556/DiRROS-31854 Insulin delivery characteristics and glycemic control in older adults with type 1 diabetes using the Minimed™ 780G system a real-world analysis Introduction: Diabetes self-management in older adults with type 1 diabetes (T1D) presents a unique clinical challenge, since maintaining tight glycemic control must be carefully weighed against age-related vulnerabilities. This study aimed to analyze glycemic control through the effects of customized algorithm settings in a cohort of older adults with T1D using an automated insulin delivery (AID) system. Methods: This retrospective real-world data analysis included users of the MiniMed™ 780G AID system, aged ≥60 years. Continuous glucose monitoring (CGM) data including time in range (TIR; 70–180 mg/dL; 3.9–10.0 mmol/L), time in tight range (TITR; 70–140 mg/dL; 3.9–7.8 mmol/L), time below range (TBR; <70 mg/dL; <3.9 mmol/L), level 2 TBR (<54 mg/dL; <3.0 mmol/L) and time above range (TAR; >180 mg/dL; >10.0 mmol/L) were analyzed alongside algorithm settings and daily insulin use. Group comparisons utilized standard parametric and non-parametric statistical tests. A multivariable logistic regression model identified independent clinical predictors of high glycemic performance (TITR ≥50%). Results: The cohort comprised 97 AID users (70.1% female, mean age 67.9 ± 6.7; range 60–90 years). Overall glycemic control was good, with mean TIR 76.1%, TITR 51.1% and TBR 1.1%. Fourteen participants (14.4%) used the manufacturer’s recommended optimal settings (ROS); i.e., target glucose of 5.5 mmol/L and active insulin time of 2 hours. CGM metrics did not differ between ROS and non-ROS users for TIR, TITR and TBR. When stratifying the cohort by glycemic performance, 55 participants (56.7%) reached TITR ≥50%; however, the adoption of ROS in high (≥50%) TITR and lower (<50%) TITR subgroups was similar (16.4% vs 11.9%; Fisher p=0.58). When compared to the lower TITR subgroup, participants in the high TITR subgroup delivered less auto-correction insulin (14.2% vs 20.6%, p<0.001) and a higher proportion of manual bolus insulin (46.1% vs 35.2%, p<0.001), which remained a significant predictor of high TITR after multivariable adjustment. TBR was significantly higher in the high (≥50%) TITR subgroup, although it remained low in absolute terms (1.5% vs. 0.8%; p=0.017). Conclusion: While the MiniMed™ 780G AID system use is associated with low CGM-derived hypoglycemia exposure and highly effective glycemic control, regardless of customized settings, superior glycemic control is associated with a higher proportion of user-initiated manual boluses. The algorithm supports, but cannot replace, user engagement. type 1 diabetes automated insulin delivery advanced technologies sladkorna bolezen tipa 1 avtomatizirano dajanje insulina napredne tehnologije true false true Angleški jezik Slovenski jezik Neznano 2026-08-12 09:08:44 2026-08-12 09:08:44 2026-08-13 03:48:33 0000-00-00 00:00:00 2026 0 0 Nasl. z nasl. zaslona; Opis vira z dne 7. 8. 2026; str. 1-9 Vol. 17 2026 0000-00-00 Zaloznikova Objavljeno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 616.379 1664-2392 10.3389/fendo.2026.1910192 287200259 RAZ_Volcansek_Spela_2026.pdf RAZ_Volcansek_Spela_2026.pdf 1 9F27D44220B3F8C1DD688E52521F5EF9 ffae0f5a92186cfd0b8ae0c8c7ebfd175025cfa6c5e6b25ba00c595ad81d8fc6 cb179a55-961c-11f1-af5a-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=49499 https://www.frontiersin.org/journals/endocrinology/articles/10.3389/fendo.2026.1910192/full 1 a8aa1d55-961c-11f1-af5a-001a4af901a5 https://dirros.openscience.si/Dokument.php?lang=slv&id=49498 Univerzitetni klinični center Ljubljana 0 0 0